Kaiser Daily Global Health Policy Report

In The News

“The Farm Bill Conference meeting kicked off Wednesday with a strong statement from Rep. Ed Royce (R-Calif.), chairman of the House Foreign Affairs Committee, calling for ‘common sense’ reforms to the U.S. international food aid program Food for Peace,” Devex reports. Royce “called on Congress to require that development groups recover 70 percent of the shipping and procurement costs associated with monetization (donating U.S.-produced food commodities to NGOs who then sell them abroad to fund programs) and allow for flexible spending on 20 percent of food aid funding instead of limiting that money to the procurement of in-kind U.S. food commodities,” the news service writes, adding, “Finally, the congressman advocated for the re-authorization and expansion of the Local and Regional Procurement program established under the 2008 Farm Bill, which would allow for more local food sourcing rather than buying American produce and shipping it overseas” (Igoe, 10/31). National Journal notes the meeting’s “tone was conciliatory and congressional farm leaders made plans to continue negotiations next week even though the House is out of session” (Hagstrom, 10/30). According to an Oxfam America press release, “a bipartisan group of more than 50 members of the [House] sent a letter to the chairs and ranking members of the House and Senate Agriculture Committees expressing strong support for [food aid] reforms contained in the Senate version of the bill” (10/22).

The number of “U.S. malaria cases are at their highest level in four decades, mostly from Americans bringing home an unwelcome souvenir from their travels,” the Associated Press reports (Stobbe, 10/31). “Some 1,925 cases were reported in the country in 2011, the most seen in a single year since 1971,” the CDC said in a report released Thursday, GlobalPost writes, adding, “Malaria cases were up 14 percent over the previous year” (Stainburn, 10/31). A CDC press release states, “Among the people who had malaria five died” (10/31). The New York Times notes “virtually all [cases] were in travelers who were infected overseas” (McNeil, 10/31). “Nearly 70 percent of the cases were imported from countries in Africa, and nearly two-thirds (63 percent) of those cases were acquired in West Africa,” HealthDay notes, adding, “For the first time, India was the country from which the most cases were imported, CDC officials said” (Preidt, 10/31).

“Three more people in Saudi Arabia have become infected with the Middle East respiratory syndrome (MERS) coronavirus and one has died, the [WHO] said on Thursday, and it also confirmed the first MERS case in Oman,” Reuters reports (Kelland, 10/31). “Globally, from September 2012 to date, WHO has been informed of a total of 149 laboratory-confirmed cases of infection with MERS-CoV, including 63 deaths,” a WHO update states (10/31). According to Xinhua, “preliminary epidemiological investigations revealed that [the man diagnosed with MERS in Oman] did not recently travel outside the country, said the WHO,” but “investigations are currently ongoing to determine what exposures might be responsible for his infection, it said” (11/1).

“Nando’s, the restaurant chain popular for its peri-peri chicken, recently announced a partnership creating the Mozambique Malaria Performance Bond, a development impact bond to fund malaria reduction efforts in Mozambique,” Devex Impact reports. “D. Capital, Dalberg’s impact investing arm, helped Nando’s create the model for the first social impact bond for malaria in Mozambique, and other partners include South African mining giant Anglo-American and Coca-Cola,” the news service writes. Devex Impact features an interview with “Sherwin Charles, a director at Nando’s who now is working full time on the company’s malaria campaign, including the bond, and David Stern, a global strategist for Nando’s who is also playing a key role in the company’s malaria work” (Saldinger, 10/31).

“Aiming to curb unhealthy consumption habits, Mexico’s Congress on Thursday approved new taxes on sugary drinks and junk food,” and “President Enrique Peña Nieto is expected to sign the taxes into law in January,” the New York Times reports. “Almost 70 percent of Mexicans are overweight, and about a third are obese, according to the [WHO],” the newspaper adds, noting, “The foundation of New York City’s mayor, Michael R. Bloomberg, financed an ad campaign to support the so-called soda tax” (Villegas, 10/31).

“Some 2,400 kilometers from New York City, where victims of Haiti’s cholera epidemic are suing the United Nations in a U.S. federal court, the disease continues to burn through the populace with no end in sight,” Inter Press Service reports. “In a single week between October 19 and October 26, the Pan-American Health Organization reported 1,512 new cases and 31 deaths,” and “[n]ew cases [were] reported in all 10 departments,” according to the news service. “The spread of cholera in Haiti, which has killed more than 8,300 and infected over 680,000 people since October 2010, has been blamed on Nepali peacekeepers who are part of the 9,500-strong U.N. Stabilization Mission in Haiti (MINUSTAH),” IPS writes, noting, “The United Nations has refused demands for compensation.” The article includes comments from former U.N. Assistant Secretary-General Kul Gautam, a Nepali who supports U.N. compensation; Mario Joseph, director of Bureau des Avocats Internationaux (BAI), which, “together with the Institute for Justice and Democracy in Haiti, is leading the lawsuit”; U.N. spokesperson Martin Nesirky; Kanak Dixit, a veteran Nepali journalist and a civil rights activist; and cholera treatment center nurse Viola Augustine (Deen/Saint-Pre, 10/31).

The National Forum of People Living with HIV/AIDS Networks in Uganda, or NAFOPHANU, on Thursday released its first-ever “stigma index,” which aims to quantify “the degree and types of stigma suffered by people living with HIV/AIDS,” VOA News reports, noting the organization “hopes that bringing the issue to light will help create policies to fight discrimination, and eventually conquer it.” The news service writes, “Based on a survey of over 1,000 HIV-positive people across the country, it found that the most common forms of stigma are gossip, verbal insults and threats.” Margaret Happy of NAFOPHANU “said this type of stigma can create shame and guilt, and often prevents people from accessing treatment,” the news service writes, adding, “‘Eleven percent of the respondents revealed that they were forced to undergo sterilization because they tested HIV-positive. Over 21 percent of the respondents revealed that they lost their jobs because of being HIV-positive,’ she said.” According to VOA, “A further 41 percent said they were excluded from family activities, and 20 percent had been physically assaulted because of their HIV status.” VOA notes, “Happy said NAFOPHANU plans to conduct the survey regularly to monitor Uganda’s progress. Similar studies have been done in Kenya, Ethiopia, Nigeria and South Africa” (Heuler, 10/30).

Editorials and Opinions

“I remain hopeful about nurturing at least a few seeds of bipartisanship this week as representatives from the House and Senate begin to negotiate a new farm bill,” Rep. Eliot Engel (D-N.Y.), a ranking member of the House Foreign Affairs Committee, writes in a Politico opinion piece. “What brings us together from across the aisle is our commitment to reform an outdated international food aid program, which is neither as effective as our humanitarian impulses demand nor as efficient as our taxpayers expect,” he states. “[S]ince 1954, the Food for Peace program has fed more than one billion people around the world,” but “this program is in urgent need of modernization,” he adds. Instead of delivering food aid through monetization, a process wherein “the U.S. government buys domestic agricultural products and donates them to charitable organizations, which sell them in developing countries,” Engel writes, “A new focus on purchasing food locally in the developing world would ensure that more hungry people are fed faster.” In addition, “buying food from farmers in poor countries would also support local economies, enabling entire countries to pull themselves out of poverty so they won’t need our aid in the future,” he writes. “Both Democrats and Republicans believe that we can and will do better,” Engel states, adding, “This growing support makes clear that comprehensive food aid reform is not a matter of if but of when” (10/31).

“Thanks to malaria elimination efforts in the United States in the 1940s, most people in the U.S. today have never had any direct contact with the disease and most doctors have never seen a case. That success means it’s easy to have a relaxed attitude about protecting ourselves,” CDC Director Tom Frieden writes in the Huffington Post’s “Global Motherhood” blog. “We’re now seeing the result of that relaxed attitude,” he states, noting a CDC report released Thursday “that finds there were 1,925 malaria cases reported in the United States in 2011 …, the highest number of malaria cases in the [country] in the past 40 years.” Frieden writes, “Almost all the cases reported in the U.S. in 2011 were acquired overseas,” adding, “It’s another example of our interconnected world. Diseases like malaria are just a plane ride away.” He continues, “People traveling to malaria-prone areas can protect themselves by taking steps such as taking antimalarial drugs, using insect repellent, sleeping under insecticide-treated bed nets, and wearing protective clothing.” He concludes, “Our progress against malaria is impressive. But vigilance remains a critical ingredient to protect the health of all people” (10/31).

Noting an estimated 70 percent of the world’s population will live in cities by 2050, Gerry Stimson of Knowledge-Action-Change and Imperial College London writes in a Lancet opinion piece, “As to be discussed at the City Health 2013 conference in Glasgow, U.K., on November 4-5, cities help to create ill health.” He continues, “Many public health experts focus on the big social challenges — reduction of inequalities, improvement of urban infrastructures, and use of taxes and controls on industry to discourage consumption of unhealthy products, but solutions to such issues are often a long time coming.” But at a local level, cities are “the focus of creative health responses, especially for healthy and unhealthy behaviors,” he states. “Some overarching actions require national strategies and infrastructure,” Stimson writes, concluding, “However, urban projects across the world show the need to foster local initiatives: the urban slum dwellers with innovative housing solutions; the AIDS activists who argue for better treatment access; urban food-cultivation projects; and community-led projects to protect sex workers from dangerous clients. Good national laws and resources cannot be substituted; but, in times of austerity, local actions count” (11/2).

Writing in a Lancet opinion piece about the history of the AIDS epidemic, Kenneth Mayer of the Fenway Institute writes, “Despite the promise of treatment as prevention and chemoprophylaxis in the short term, and vaccines and cures in the longer term, immediate attention to the social, legal, and regulatory environment globally are needed to constrain, and ultimately end, the epidemic.” He concludes, “HIV is a wily beast, but recent insights seem to offer tangible clues about how to begin to consign the AIDS pandemic to the dustbin of history” (11/2). The Lancet also includes a profile of Mayer, writing he “is best known for a series of groundbreaking HIV prevention trials” (Das, 11/2).

Recent Releases

The Global Network for Neglected Tropical Diseases’ “End the Neglect” blog reports on an October meeting between the Global Network’s Managing Director Neeraj Mistry, Sabin Foundation Europe Board Member and Chair of the U.K. All-Party Parliamentary Group on Malaria and Neglected Tropical Diseases (NTDs) Jeremy Lefroy, National Assembly of Niger Member Ibrahim Souleymane, and Sen. Roger Wicker (R-Miss.). Noting “Sen. Wicker, who currently co-chairs the Senate Working Group on Malaria and NTDs (Working Group) with Sen. Christopher Coons (D-Del.), has a long track record of supporting global health issues and other foreign assistance programs,” the blog writes, adding, “Support from lawmakers like Sen. Wicker remains essential to ensuring that the U.S. Congress continues to fund and raise awareness for important global health initiatives like USAID’s NTD Program” (Brooks, 10/31).

“As researchers, clinicians, patients, funders, civil society, and public health practitioners engaged in research and development (R&D) and implementation of treatment and prevention programs, we have decided to join forces to create a coalition aimed at changing the future of Chagas disease,” a group called the Global Chagas Disease Coalition writes in the PLOS “Speaking of Medicine” blog. They call for improved access to treatment; an improved global Chagas disease R&D agenda; “prevention of different forms of transmission in endemic and non-endemic countries”; and increased public and policy awareness of the disease (10/31). In PLOS Neglected Tropical Diseases, Peter Hotez, co-editor in chief of the journal and dean of the National School of Tropical Medicine at Baylor College of Medicine, and colleagues write about the increasing number of Chagas cases in North America and call for improved surveillance data (10/31).

“Many of the most terrifying Halloween archetypes have very real counterparts, with very real health consequences,” Victoria Fan, a research fellow at the Center for Global Development (CGD), and Rachel Silverman, a consultant and candidate for MPhil in Public Health at the University of Cambridge, write in the center’s “Global Health Policy” blog. They describe malaria-carrying Anopheles mosquitoes as vampires, reemerging diseases — such as measles, pertussis, and mumps — as ghosts, antibiotic-resistant bacteria as mutants, “virulent and deadly new pathogens” such as SARS and the Middle East respiratory syndrome coronavirus (MERS-CoV) as zombies, those injured in road accidents as mummies, and note the global burden of anxiety disorders, calling it “fear itself.” They write, “Despite all these real-world scares, there’s no need to panic; while no rigorous evidence suggests that stakes or garlic are particularly efficacious, most global health monsters can be stopped with cheap and effective vaccines, prophylaxis, or remedies” (10/31).